Does pleural tuberculosis have a cure? How is the treatment?

Expert answer:

Yes, pleural tuberculosis has a cure. Treatment is usually done with regimens up to 4 medications antibiotics, taken orally: rifampicin, isoniazid, pyrazinamide and ethambutol.

The treatment of pleural tuberculosis has a minimum duration of 6 months, and can be extended for up to 12 months, depending on the case.

Patients who have never received any treatment for tuberculosis or who have taken the drugs for less than 30 days are treated with scheme 1, which includes 3 antibiotics:

⇒ 1st phase (2 months): Rifampicin + Isoniazid + Pyrazinamide.

⇒ 2nd phase (4 months): Rifampicin + Isoniazid.

If the evolution is not favorable, the second phase can be extended for another 3 months. The chance of cure of pleural tuberculosis with this regimen is 98% as long as the treatment is properly done and is not discontinued.

Patients who have already been cured of tuberculosis with regimen 1 and return to having the disease or who have previously discontinued treatment are treated with Scheme 1R (reinforced), which includes 4 antibiotics:

⇒ 1st phase (2 months): Rifampicin + Isoniazid + Pyrazinamide + Ethambutol.

⇒ 2nd phase (4 months): Rifampicin + Isoniazid + Etambutol.

When schemes 1 and 1R do not work, the scheme 3, which have a duration of 12 months and also includes 4 medicines:

⇒ 1st phase (3 months): Streptomycin + Ethionamide + Etambutol + Pyrazinamide.

⇒ 2nd phase (9 months): Ethionamide + Ethambutol.

Streptomycin is the only drug given by injection or serum. All other antibiotics used to treat pleural tuberculosis are taken orally.

The cure rate of scheme 3 ranges from 55 to 65%. In addition to the drugs being less effective, the side effects and the need to have to take injections for 3 months (streptomycin) increase the rate of abandonment of this treatment.

Tuberculosis treatment is available free of charge by the Unified Health System (SUS).

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